Micturition symptoms in gynecologic cancer patients receiving paclitaxel and platinum-based chemotherapy regimen: a prospective study

Objective To evaluate the effect of paclitaxel and platinum-based chemotherapy (PT) on micturition symptoms. Methods All gynecologic cancer patients who were assigned to receive the PT regimen and understood the Thai language were invited to participate in this study. The exclusion criteria were as follows: abnormal urinary symptoms, retained urinary catheter or percutaneous nephrostomy, anticholinergic drug use, or scheduled to receive radiation therapy after the completion of chemotherapy. The participants were interviewed using three Thai validated questionnaires, the incontinence impact questionnaire-short form, urogenital distress inventory short form, and Sandvik score, on the day before receiving the first cycle of chemotherapy (pre-treatment), on the day before receiving the 4th cycle (mid-treatment), and 46 weeks after completing 69 cycles (post-treatment). The scores at the three time points were compared. Patients who received less than three cycles were not included in the analysis. Results One hundred and ten patients were included in this study. There were significant differences in the median questionnaire scores at the three time points for both carboplatin plus paclitaxel and cisplatin plus paclitaxel. However, when using a pairwise difference between the two treatment protocols, there were no significant changes in the score from pre-treatment to post-treatment. Conclusion The PT regimen has an impact on micturition symptoms during chemotherapy which recover after treatment completion

Uptake of COVID-19 Vaccination and Related Factors Among People who Inject Drugs, San Francisco, 2022

We assessed the uptake of COVID-19 vaccination in a community-recruited sample of people who inject drugs (PWID) in San Francisco in 2022. Overall, 72.4% (95% CI 64.6-80.3) were vaccinated for COVID-19. Independent predictors of vaccination were age 65 years and older (adjusted odds ratio [AOR] 9.7, 95% CI 2.2-28.7) and ever testing positive for COVID-19 (AOR 2.0, 95% CI 1.2-3.5). Homelessness was associated with lower COVID-19 vaccination (AOR 0.5, 95% CI 0.3-0.8). Our study underscores the urgent need for targeted interventions to address unique challenges faced by PWID in accessing COVID-19 vaccination, particularly for those experiencing homelessness and who are younger

The Prevalence of High Risk Human Papilloma Viral Infection and Abnormal Cervical Cytology in Faculties of Medicine and Nursing, Chiang Mai University Population

Objective:To evaluate the prevalence of high risk HPV infection and abnormal liquid based cytology (LBC) in healthcare population of Faculty of Medicine and Nursing, Chiang Mai University.Material and Method:Healthcare population who aged ≥ 30 years and no history of preinvasive or invasive cervical cancer from both faculties were invited. LBC was done by collecting a specimen into Thin Prep Pap test solution and Cobas® 4800 was used for high risk HPV testing. The persons with abnormal cytology and /or HPV type 16/18 positive were referred for colposcopy. Results: Between September, 2012 and April, 2013, 261 persons joined this project. Sixteen persons (6.1%) revealed abnormal cytology that consisted of ASCUS ten persons, LSIL four persons and HSIL two persons. Positive HPV test were also found in 16 persons (6.1%). Twelve persons (4.6%) showed positive only in the cytology or HPV tests while four persons tested positive in both methods. HPV type 16 was detected in one person and HPV type 18 was detected in two persons. With 17 persons who were referred for colposcopy, the colposcopic-directed biopsy and conization were done in seven and three persons, respectively. Of these persons, the histology showed chronic cervicitis in three persons, LSIL in four persons and HSIL in three persons. One HSIL person revealed only HPV type 16 positive without abnormal cytology.Conclusion: The prevalence of high risk HPV infection and abnormal cytology seems to be minimal in healthcare population. Infected HPV type 16/18 persons should be referred for colposcopy even with normal cytology

Factors associated with the completion of syphilis treatment among transgender women and travestis, in five Brazilian capitals, 2019-2021: a multicenter cross-sectional study.

OBJECTIVE: To assess the previous history of syphilis in transgender women and travestis (TWTs) and identify factors associated with treatment incompleteness. METHODS: : This was a multicenter cross-sectional study conducted between 2019 and 2021, with participants recruited through respondent-driven sampling, in five Brazilian capitals. Dependent variable: reported syphilis treatment in the last year, no/incomplete or complete. A multivariate-logistic model was used to identify factors associated with completeness. RESULTS: : Of the 1,317 participants, 16.0% reported previous history of syphilis. Of these, 68.9% were Black, 54.6% earned up to 1 minimum wage and 61.1% completed the treatment. Treatment completion was lower in São Paulo (42.7%) and among those who experienced verbal abuse (53.6%; ORa 0.46; 95%CI 0.25;0.85). CONCLUSION: In this sample, both the prevalence of self-reported syphilis and the proportion of participants who reported not having started/completed treatment were high. It is essential to identify the barriers faced by TWTs that hinder healthcare access, and identify their needs in order to ensure adequate diagnosis and treatment. MAIN RESULTS: Of the 16% of participants who reported a previous diagnosis of syphilis, only one-third completed the treatment. Residents of São Paulo were less likely to complete it compared to those from other cities, and those who had experienced verbal abuse. IMPLICATIONS FOR SERVICES: There is a need for healthcare professionals to receive training focused on specific needs of TWTs , including respect for their social names, extended opening hours, point-of-care strategy and alternatives for the administration of intramuscular benzathine penicillin injections. PERSPECTIVES: It is crucial to develop new, more effective therapeutic methods for syphilis treatment and deepen research on the impacts of discrimination and stigma on transgender women and travestis access to healthcare, especially diagnosis and treatment of sexually transmitted infections

Increased vulnerability to psychological distress and suicidal ideation among transgender women with self-reported disabilities in San Francisco, California

OBJECTIVE: Research among transgender women has found health, but especially mental health, to be shaped by social inequities and multiple, intersectional, structural vulnerabilities. While some studies have shown that transgender adults are also more likely to have a disability than cisgender adults, few studies have explored this intersection. We assess possible associations between disability status and psychological stress and suicidal ideation among transgender women. METHODS: We analyzed data from the San Francisco site of the National HIV Behavioral Surveillance Transgender (NHBS-Trans) Study (2019–2020) to explore how disability status among transgender women influences mental health. Chi-squared and Fisher's exact tests to assess associations between disability status and psychological distress. Multivariable logistic regression models assessed the magnitude of these associations adjusted for potential confounders. RESULTS: 71.14 % of the sample (N = 201) reported living with one or more disabilities. Participants with 1+ disabilities had more than 10 times the odds of reporting high levels of psychological distress (aOR 10.46, 95 % CI 3.06–35.74) and more than five times the odds of reporting suicidal ideation (aOR 5.83, 95 % CI 1.69–20.15) compared to those with no disabilities. Participants with 2+ disabilities had 10+ times the odds of reporting suicidal ideation compared to participants with no disabilities (aOR 10.77, 95 % CI 2.94–39.51). CONCLUSIONS: Transgender women living with disabilities face multiple intersecting inequities likely attributable to living in a world that is not built for them on the basis of gender identity and disability status. The resulting psychological distress, alongside transphobia and ableism, can exacerbate mental health issues

Knowledge, Attitudes, Practices, and Acceptance of Gynecologic Cancer Patients Toward Covid-19 Vaccine in Thailand: A Multicenter Cross-sectional Study

OBJECTIVE To evaluate the knowledge, attitudes, practices (KAP), and acceptance of gynecologic cancer patients from the 4 regions of Thailand related to the COVID-19 vaccine. METHODS Gynecologic cancer patients from Chiang Mai University Hospital, Khon Kaen University Hospital, Khon Kaen Hospital, Prince of Songkhla University Hospital, and the National Cancer Institute (NCI) in Bangkok were surveyed using a WHO survey instrument. RESULTS Between February and September 2022, 1,263 patients partici-pated in this project of whom 1,084 (85.8%) had received the COVID-19 vaccine. The highest rate of vaccination was the NCI followed by Khon Kaen, Chiang Mai, and Songkhla. Of the participants, 28.2% were infected with COVID-19 and 12.9% of the infected participants were unvaccinated. Regarding KAP, the average scale level of overall participants reported ease in obtaining health literacy, a moderate probability of having severe COVID-19 infection, knowledge and adoption of proper appropriate behavior for the prevention of COVID infection, little stress regarding possible COVID-19 infection, and quite a lot of a significant level of trust in healthcare workers. Most participants generally agreed with the lifting of some regular rules to reduce the risk of infection and often many expressed a feeling of general well-being. The significantly different levels of rating scale by unvaccinated and vaccinated participants in the key areas were as follows: (Patients rated each of the areas investigated on a scale of 0 to 6, with 0 indicating lowest level of agreement/acceptance and 6 indicating the highest level) health ministry recommendations (3.92 vs. 4.16), ease of getting the COVID vaccine (3.6 vs. 3.9), “no need to receive the vaccine due to the disease being rare” (2.6 vs. 2.2), “stress made me not want to get vaccinated” (2.6 vs. 2.1), “if everyone is vaccinated, no need for me to vaccinate” (2.5 vs. 1.9), and the importance of COVID-19 vaccines (3.7 vs. 4.2). CONCLUSIONS Most gynecologic cancer patients from the 4 regions of Thailand had received the COVID-19 vaccine and exhibited good knowledge, attitudes, and practices related to this pandemic. KEYWORDS COVID-19-vaccine, gynecologic cancer patients, attitude, practic

Ruptured ovarian cystic teratoma in pregnancy with diffuse peritoneal reaction mimicking advanced ovarian malignancy: a case report

<p>Abstract</p> <p>Introduction</p> <p>This case illustrates the unusual complication of granulomatous peritonitis following rupture of a dermoid cyst in pregnancy resembling disseminated ovarian carcinoma. To the best of the authors' knowledge, this is the first report of this complication during advanced pregnancy in the literature.</p> <p>Case presentation</p> <p>A dermoid cyst ruptured during surgical removal in the second trimester of pregnancy in a 27-year-old primigravida. Postoperatively the patient suffered pulmonary embolism and leakage of sebaceous material through the abdominal wound. She gradually developed significant abdominal distension, gastrointestinal symptoms and lost more than 8 kg of weight in the 12 weeks postoperatively. The baby was delivered at 31 weeks by a technically challenging caesarean section owing to severe dense adhesions obscuring the uterus. Bowel resection was performed for suspected malignant infiltration and adhesion causing obstruction. She had a protracted convalescence with an ileostomy and mucus fistula. Histology confirmed granulation without malignancy. One year following the surgical treatment, she had recovered well and was planning her next pregnancy.</p> <p>Conclusion</p> <p>Although granulomatous peritonitis following rupture of a dermoid cyst is very rare, awareness is the key to diagnosis and appropriate management. Per-operative frozen section may be helpful.</p

Relationship stigma negatively impacts the relationship quality of trans women

Trans women face negative health outcomes due to multiple types of anti-trans stigma. Relationship stigma, or when people experience stigma because their romantic partnerships are devalued by society, can negatively impact experiences in relationships of trans women. Relationships and their quality are important predictors of wellness across populations, but little is known about relationship quality for trans women. This study was conducted to determine whether relationship stigma is associated with relationship quality for trans women with main partners. This is a secondary analysis of data from 89 trans women with main partners enrolled in the 2020 Partners Study, an online, interviewer-administered, cross-sectional survey of trans women in the San Francisco Bay Area. Multivariate logistic was used to test for an association between relationship stigma and relationship quality among trans women with main partners. The trans women surveyed were White (29.2%), Latinx (24.7%), or multiracial (23.6%), with the majority having never been married (65.2%). Those who often felt they must hide their partnerships had significantly lower odds of reporting satisfaction with intimacy and closeness in their relationships [odds ratio (OR): 0.07; 95% confidence interval (CI): 0.01–0.68, p = 0.02] and of reporting satisfaction with their overall relationship (OR: 0.02; 95% CI: 0.02–0.34, p &lt; 0.01). Those whose families were not supportive of their partnerships had significantly lower odds of reporting relationship satisfaction, intimacy, and closeness with their main partners (OR: 0.08; 95% CI: 0.01–0.85, p = 0.04) and of reporting satisfaction with their overall relationship (OR: 0.08; 95% CI: 0.00, 0.51, p = 0.01). Relationship stigma was negatively associated with relationship quality for trans women with main partners in this study. Stigma from family also had a significant negative impact on relationship quality, suggesting the important influence of family on trans women's relationships. Efforts to boost family support may foster intimacy and improve relationship satisfaction for trans women in main partnerships

Radical hysterectomy for FIGO stage I–IIB adenocarcinoma of the uterine cervix

A retrospective analysis was carried out to identify risk factors for survival and relapse in patients with FIGO stage I–IIB cervical adenocarcinoma (AC), who underwent radical hysterectomy, and to compare outcome and spread pattern with those of squamous cell carcinoma (SCC). One hundred and twenty-three FIGO stage I–IIB patients with AC and 455 patients with SCC, who all underwent primary radical hysterectomy, were reviewed. Among the patients with AC, Cox model identified tumour size (95% CI: 1.35–30.71) and node metastasis (95% CI: 5.09–53.44) as independent prognostic factors for survival, and infiltration to vagina (95% CI: 1.15–5.76) and node metastasis (95% CI: 6.39–58.87) as independent prognostic factors for relapse. No significant difference was found in survival or relapse between the AC and SCC groups, after adjusting for other clinicopathological characteristics using Cox model. No significant difference was found in the positive rates of lymph nodes or location of initial failure sites between the two groups, but ovarian metastatic rate was significantly higher in patients with pathologic stage IIB AC (P=0.02). Positive node is a common independent prognostic factor for survival and relapse of patients with AC. FIGO stage I–IIB patients with AC or SCC, who underwent radical hysterectomy, have similar prognosis and spread pattern, but different ovarian metastasis rates